1. Field of the Invention
This invention relates generally to the field of laparoscopic surgery and more specifically to a laparoscopic suction/irrigation valve. This valve incorporates a metering feature which is incorporated into the suction valve mechanism of the valve and is used for maintaining clear visibility in the operative field free from laser plume and/or smoke associated with laser and/or electrosurgical procedures.
2. Description of the Prior Art
The increasing use of laparoscopic surgical techniques for performance of a variety of surgical procedures have presented the clinician/surgeon with both new opportunities and new challenges. Where, as in the past, the abdominal cavity was exposed by relatively large incisions, the laparoscopic surgical technique permits access to the surgical site through relatively small incisions referred to as puncture sites through which trocars are inserted. In practice the abdominal cavity remains "closed", inflated however by positive pressure thus distending the abdominal cavity to allow the surgeon access to one or more tissues and/or allows him to relocate lower intestine and/or bowel to reveal other areas within the cavity. Where in the course of the laser procedure and/or electro-surgical procedure, a target tissue is vaporized, electrosurgically cut, or cauterized. The generation of plume and/or smoke and gases are within the confines of the abdominal cavity is produced that will obscure the surgeon's view of the operative field as seen through the imaging bundle of the laparoscope. In such event, the operative procedure is delayed unless or until the obscuring smoke is suctioned by manual depression of the suction button or evacuated by venting the abdominal cavity through a controlled bleed of gas. Such venting has been typically accomplished through a stop cock valve, which is an integral part of a trocar, which is inserted and positioned through the abdominal cavity. This venting allows gas with smoke and plume to exit the abdominal cavity and escape into the operating theater. As smoke is hazardous and can contain airborne pathogens, viruses and toxic gases, this venting is hazardous to the operating room personnel and also a direct violation of proper operating room protocol.
The surgeon is therefore required to evacuate such gas by consciously applying (periodically) suction through a suction/irrigation probe. The surgeon must, thus, divert his effort from other functions and divide his time between performing the surgical procedure and the periodic activation or continuous application of the suction function through the suction irrigation probe, the amount and duration being determined empirically. Where the surgeon is required to perform such clearance of the operative field, his attention is obviously diverted from the task at hand, the operative procedure prolonged and the patient exposed to increasing risk. As is further apparent, the surgeon's ability to efficiently evacuate the plume and/or smoke is, at best, based upon imperfect balancing of the amount of suction, relative to the pressure of the insulflation apparatus. Many times the positive pressure inflation of the abdominal cavity (pneumoperitoneum) is loss and time is wasted while the operation room staff waits for the pneumoperitoneum to again be established.
As is apparent from the foregoing discussion, the increase in the use of laser and/or electro-surgery for localized removal and/or cauterization of tissue within the abdominal cavity has been limited by the plume/cloud which is produced upon vaporization of tissue within the operative field. Unless and until such visually limiting smoke/plume can be dissipated and/or evacuated effectively from the field, the field of view is obscured and the surgical procedure is prolonged and the patient forced to endure unnecessary discomfort/risk. The techniques adopted heretofore for addressing this problem have been generally inadequate for reasons set forth above. Accordingly, there is and remains a continuing need to provide both an improved instrument and technique to effect metered and/or rapid evacuation of gas/smoke from the operative field in a manner which permits essentially uninterrupted performance of the surgical procedure associated therewith. It is, therefore, to the effective resolution of the aforementioned problems and shortcomings that the present invention is directed.